Healthcare Provider Details

I. General information

NPI: 1275924284
Provider Name (Legal Business Name): TYLER HALFORD PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/12/2015
Last Update Date: 06/04/2021
Certification Date: 06/04/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

314 N LAST CHANCE GULCH STE 204
HELENA MT
59601-5012
US

IV. Provider business mailing address

2670 CODY DR
EAST HELENA MT
59635-3443
US

V. Phone/Fax

Practice location:
  • Phone: 775-742-2010
  • Fax:
Mailing address:
  • Phone: 775-742-2010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License NumberPSY-LIC-3546
License Number StateMT
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: